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General NPI Number Information
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NPI Number | 1083488829
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Entity Type | Organization
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Legal Business Name | PROCARE FAIRFIELD LLC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 15103 MASON RD STE E-1
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City | CYPRESS
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State | TX
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Zip | 77433-6755
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Country | US
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Telephone | 832-619-7937
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Fax |
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Provider Business Mailing Address
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Address Line | 2703 TELECOM PKWY STE 140A
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City | RICHARDSON
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State | TX
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Zip | 75082-3507
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Country | US
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Telephone | 469-436-8100
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Fax | 469-436-8111
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Authorized Official
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Title or Position | MANAGER
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Name | RICK HARRISON
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Credential |
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Telephone | 469-436-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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